Friday

For weeks now, Samantha Kilano has kept her husband and 11-month-old daughter safe in their Vallejo, California, home, shopping for groceries online to avoid any potential exposure to COVID-19.

She clicks from website to website on the constant prowl for formula as her two containers slowly dwindle to a few scoops. Kilano finally located Nido formula on Instacart, but the price had gone up, a tough hit to the family’s finances that are especially strained after her husband's construction gigs dried up with coronavirus fears and the state shutdown.

“I’m glad that my baby is 11 months old and not smaller, or else this formula issue would’ve stressed me out much more,” she says, “but it’s still extremely stressful.”

Here's welcomenews for worried parents and caregivers like Kilano: formula, which vanished during a nationwide run on baby supplies, could start flowing back onto store shelves in the next week or two. In some areas, it’s already much easier to find.

The reason? Manufacturers ramped up production and worked hand in hand with retailers and government agencies to uncork bottlenecks that for weeks made formula frighteningly scarce. Stores in areas where there were acute shortages started limiting purchases so more families could stow a container or two in shopping carts.

“We will probably see sporadic unavailability for the next few weeks or maybe even months, but it is not likely to last beyond that,” says John Aloysius, professor and Oren Harris chair in logistics supply chain management department at the University of Arkansas.

Even on the lengthy list of life-altering shortages during the COVID-19 pandemic, baby formula gives new meaning to the term essential. No coronavirus deprivation, not toilet paper, not hand sanitizer, hits closer to home than formula for parents of infants who need it to survive.

Formula is the only substitute for breastmilk until babies begin eating mashed foods at 4 to 6 months old. And some 8 out of 10 women use formula in their child’s first year of life.

“God forbid we run out of toilet paper, but we’ll figure something out. But formula is where the buck stops. If you don’t have formula to feed your child, you are not feeding your child,” says Laura Modi, CEO and co-founder of Bobbie, a baby formula startup in San Francisco expected to launch later this year. “And that is a very scary situation to be in, and frankly it is just downright unacceptable.”

Formula maker Enfamil says it’s aware of baby formula shortages at some retailers and “will do everything possible to ensure you don’t run out of formula.”

Similac says its manufacturing plants are fully staffed and operating and it has seen no impact on the availability of Similac products. “But we are aware that some parents are still unable to find product (on) the shelf, which we know is concerning,” the company says. “We are currently doing all we can to ensure ongoing and consistent distribution of our products with retailers.”

So why have families been having such a hard time finding formula?

As the nation braced for shortages of goods and shelter-in-place orders, parents and caregivers were advised to stock up on formula, enough to last 10 days to two weeks. Preparing for the possibility that they could be quarantined for weeks or even months, some families loaded up their carts with far more than that, straining supplies at the worst possible time.

The main challenge for formula makers was how to get formula “to the right store in the right region at the right time,” Aloysius says.

Modi, mother of two toddlers who is pregnant with her third child, doesn’t blame the formula shortage on parents trying to feed their children. She says the $70-billion baby formula industry should have seen the pandemic coming and better prepared for it.

“The last month has really taught us that infant formula should have been pandemic proof, but sadly it’s not,” Modi said in an interview.

►How it works: The industry analyzes years worth of buying patterns to predict how much formula it needs to produce at any given time and then relies on a massive supply chain to deliver it, from the suppliers of the more than two dozen nutrients to the manufacturing plants to every truck and rail car, warehouse, and distribution center along the weeks-long journey of depositing containers on store shelves or doorsteps.

The entire process, from stores placing an order to receiving formula, usually takes from 12 to 16 weeks, Modi says. When pandemic fears began to trickle into the U.S. late last year and early this year, formula makers should have kicked production into high gear but didn’t, she says.

“It has definitely gotten the wheels turning on ‘how do we make sure there is always a backup and be able to fast track orders?’” she said. “Because 16 weeks is just too long to be able to stock shelves.”

The formula industry says it was blindsided by the sudden surge in buying that has led to shortages for everything from face masks to hand sanitizer across the country.

“In order to meet the evolving demands driven by new consumer buying behavior in the midst of the COVID-19 pandemic, manufacturers have increased production, and are working with retailers and government agencies to help ensure adequate availability of and continued access to infant formula,” Mardi Mountford, president of the industry group Infant Nutrition Council of America, told USA TODAY in a statement.

Hopeful signs that stores will soon have more infant formula

Encouraging signs abound that the formula shortage, at least for now, may be short-lived, supply chain experts say.

Freight transportation capacity, stretched thin early in the public health crisis, is returning to normal levels, says Matt Waller, dean of the Walton College of Business at the University of Arkansas. And, he says, no one is more eager than retailers to restock shelves.

Demand for formula is steady. And formula is a destination item, meaning shoppers will make a trip to the store when they are low on it and pick up other goods while they are there.

One hitch: It may take a while for anxious parents to shake off their fears and stop buying more than they need when they spot formula for sale online and off, says Rudolf Leuschner, associate professor of supply chain management at Rutgers Business School.

“As soon as there is some supply, customers keep buying it all up,” Leuschner says. “Even if manufacturers are trying to raise production, it may not be that easy because they may have to produce more of their other products as well. There is only so much you can raise production.”

The formula industry is urging parents not to stockpile and limit their purchases to a seven- to 10-day supply.

It will still be months before shelves are full again

And, while formula may get easier to find online and off, don't expect a swift return to the good old days of fully stocked shelves and regular prices, warns food and drink analyst Billy Roberts.

His best guess: It could be three to six months before we see formula containers stacked high and deep on store shelves or just a click or tap away on the internet. He also expects retailers to continue to ration baby formula until supplies become more plentiful.

Specialty formulas such as Alimentum and Nutramigen – hypoallergenic, more easily digestible blends for babies with food sensitivities who cannot tolerate regular formula – “can be a challenge for sure” and can cost almost twice as much as milk-based formula, says Roberts, an analyst with market research firm Mintel.

“Parents will be able to find what they are looking for, but they are not going to see those copious amounts of formula on store shelves that they may have been accustomed to seeing,” he says. “That could cause a degree of concern among parents, and I can certainly understand why. You are used to picking up your jar of formula and still seeing six and seven in a row behind it. That may not be the case for a while, and it’s tough to gauge when that may change.”

Formula shortage hits low-income parents hardest

Any kind of formula shortage worries parents and caregivers at all socioeconomic levels, but is by far hardest on low-income parents and millions of Americans who’ve recently lost jobs to the coronavirus-spurred downturn.

If they qualify, a safety net exists with Supplemental Nutrition Assistance Program or SNAP, formerly known as food stamps, and the Special Supplemental Nutrition Program for Women, Infants and Children, known as WIC, but these programs don’t cover everything and come with strict guidelines.

WIC participants, low-income pregnant and breastfeeding mothers with children under age 5, get a monthly check, voucher or card to buy groceries, but guidelines restrict their purchases to certain brands and sizes. If a brand or size of WIC-eligible formula is sold out, WIC recipients have to hit several stores to find what they need, increasing their potential exposure to the coronavirus. They are also not allowed to use vouchers to buy formula online and some curbside delivery is also unavailable to them.

With that in mind, Enfamil says it’s doing everything it can to keep WIC products on store shelves.

“We’re working around the clock to produce and ship our products to stores,” the company said on its website. “New inventory is arriving daily.”

Some WIC requirements have been relaxed during the pandemic through special waivers, such as allowing applicants to fill out paperwork remotely rather in person.

And, as formula fills up shelves again, WIC families will have an easier time locating it, says Douglas Greenaway, president and CEO of the nonprofit advocacy group the National WIC Association, a nonprofit advocacy group.

Family advocates are urging parents and caregivers to check for the WIC label to make sure you do not buy those products if you can buy other kinds of formula.

“From what we are hearing from state WIC agencies and local WIC agencies, there are isolated issues, but really this has been turned around,” Greenaway said in an interview.

“I feel a level of confidence that, what we had at the outset, is just not the case now.”

Shortages persist as demand grows

Not everyone is feeling so confident.

Baby2Baby, a nonprofit that provides children living in poverty with basic necessities such as formula, says it's been flooded with requests for formula and the demand is growing. In one afternoon this week, the Red Cross asked Baby2Baby for an additional 5,000 and FEMA an additional 2,000 containers of formula.

"The low-income families we serve struggle to afford it compounded by the fact that they can’t access it because of empty shelves in their local markets and lack of transportation," Baby2Baby’s co-presidents, Norah Weinstein and Kelly Sawyer Patricof, said in a statement to USA TODAY. "On our end, it is increasingly difficult to purchase because our wholesalers are out of inventory and dealing with their own factory shutdowns."

The alternatives, such as parents being forced to water down formula, are unacceptable, they said.

Modi is encouraging families who have stocked up on formula to donate formula or money to families or nonprofits that need it.

“We are going to get to a point where the peace of mind for a lot of moms is going to return, but there are still a lot of nonprofits out there who are trying to meet the needs of a different socioeconomic group,” she says. “If all those formula moms who’ve got peace of mind today were able to help out a mom who doesn't have that peace of mind yet, that would be huge.”

Having trouble finding formula? Here’s what to do

Use store locators: Formula makers are urging people to check the store locators on their websites to find local retailers that sell your brand and type of formula. Call ahead to see if the formula is in stock.

Order online: Hit up retailers' websites or order directly from manufacturers. Bear in mind that manufacturers may restrict how many containers of formula you can buy and how often.

Shop stores big and small: Don’t just stick to the mega-retailers like Walmart and Target, warehouse outlets like Costco or major grocery chains. Many parents have been able to track down formula at local pharmacies, convenience stores and baby specialty stores.

Find out when formula is restocked: Ask to speak with a manager to find out when the store gets more inventory.

Check with your pediatrician and nonprofits: Local food banks, nonprofits such as Feeding America and government agencies may have formula on hand for emergency situations, especially for children under 6 months. Your pediatrician may have samples or may be able to request a can of formula for your family from formula representatives, local hospitals or nonprofits, says Dr. Steven Abrams, a professor of Pediatrics at the Dell Medical School at The University of Texas at Austin and chair of the American Academy of Pediatrics’ Committee on Nutrition. Local WIC offices may also be able to help. You can also dial 211 to be connected to a community resource specialist who can help you find local resources.

Tap your friends, social networks: Ask your friends if they have a container or two to spare. Spread the word of your formula needs on Facebook and Nextdoor. Post in parenting groups on social networks.

Be flexible: If you don’t use a specialty formula, consider switching to store brand or generic formula with similar ingredients or consult your pediatrician about other possible substitutes.

Add more solids: For babies older than 6 months, parents can try more iron-rich solid foods such as kale and spinach, sweet potato, eggs and beans. “I encourage families to puree their own food,” says Dr. Esther Chung, professor of pediatrics at the University of Washington.

Short on formula? Here’s what not to do

You can skip eBay: Don’t buy formula secondhand from third parties on auction sites or from individuals on social media or the internet. The formula could be expired or contaminated or may have been improperly stored or shipped. Watch out for dents, punctures or any sign the formula has been tampered with, the Infant Nutrition Council of America advises.

Don’t water down formula: Always follow instructions on the label or from your pediatrician. Diluted formula does not provide adequate nutrition and, if fed for an extended period of time, can lead to slower growth and risk of malnutrition, pediatricians say. Excessive water consumption can also result in seizures or even death.

“It may be tempting to dilute the formula to make it last longer, but it is important to mix the formula correctly,” says Dr. Icy Cade-Bell, associate professor of pediatrics at the University of Chicago. “Watered-down formula does not supply the calories needed, but can also lead to abnormal electrolyte levels in the baby's blood which can cause seizures.”

Don’t make your own formula: Recipes for homemade infant formula circulating on the internet that can contain raw, unpasteurized cow, goat or sheep milk, may lack the right nutrients to support growth and brain development and could even be unsafe. “We don’t feel like there is a safe way to prepare your own formula,” Chung says. “The way that formula is compounded and prepared is according to strict mixing guidelines.”

Be wary of substitutes: Do not give milk alternatives to infants under 6 months. If your baby is nearly 1 year old, consult your pediatrician about switching to cow’s milk early, Abrams advises. Cow’s milk is generally not recommended for children under the age of 1, as they cannot digest cow’s milk as easily. If you do switch to cow’s milk, experts advise, make sure your child is eating iron-rich foods as cow’s milk does not contain enough iron to meet a baby’s needs. Avoid almond milk, condensed milk or other milk substitutes that are too low​ in protein, vitamins and minerals, Chung says. Never give your baby water or juice, Chung says.

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